Risk and resilience in the cognitive functioning of children born to HIV-1-infected mothers: A preliminary report

Although biologic and environmental risk factors show an age-dependent effect on children's cognitive development, outcome studies have yet to consider the role such factors play in the development of children born to HIV-1-infected women. This study explored the age-dependent differential impact of such risk factors on the cognitive functioning of children exposed in utero to HIV-1. Eighty-two children were administered a standardized measure of cognitive functioning and divided into two groups depending on their age when tested. Group 1 included children age 2 to 29 months (n = 46); Group 2 included children age 30 to 101 months (n = 36). Correlations between cognitive test scores and specific risk factors revealed an age-related double-dissociation. Serostatus and percent of CD4 cells correlated moderately with cognitive test scores in Group 1; however, these correlations were attenuated and nonsignificant in Group 2. Conversely, caregiver status and cognitive test scores were uncorrelated in Group 1, but were correlated in Group 2. These findings support a risk and resilience model of development. That is, in the context of biologic risk factors, aspects of the child's environment may either facilitate or hinder cognitive development.